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Emergency Medicine, Global Health, Haiti, Stanford News

A tale of two earthquakes: Stanford doctor discusses responses to the Nepal and Haiti disasters

A tale of two earthquakes: Stanford doctor discusses responses to the Nepal and Haiti disasters

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Nepal’s 7.8 earthquake in late April killed 8,000 people and displaced thousands more. Paul Auerbach, MD, a professor of emergency medicine at Stanford, spent about a week caring for the people of Kathmandu and recently sat down for a Q&A session with Shana Lynch of Stanford’s Graduate School of Business, where Auerbach earned a master’s degree in 1989.

Auerbach was also part of the medical response team in Haiti after the 2010 earthquake there killed hundreds of thousands. While talking with Lynch, he compares the two earthquakes and the very different medical responses they needed:

When you come in, you need to find the victims. You need to treat them. You need medical supplies. You need adequate personnel in order to manage the life- and limb-threatening injuries in the first few days. From the moment of the earthquake and forward, there’s a need for water and food. In Haiti, the supplies initially weren’t there. Everything needed to be carried in. In Kathmandu, for the most part, the supplies were available. Of course, they needed supplementation, and that happened and will continue to happen. In Kathmandu, they never were in a situation where they had nothing, which was unfortunately the situation in Port-au-Prince.

He also discusses some of the challenges of coordinating an appropriate disaster response plan:

There comes a point when you have enough people and enough supplies. At that point, you need to start storing things and sending people home.

The responses are never perfect because you discover that you need more of something and less of something else. The same holds true for people. For example, the changing nature of medical conditions following an earthquake causes you to need emergency medicine specialists early on, but then orthopedic surgeons and reconstructive surgeons later during the response.

Lynch and Auerbach’s conversation also touches on why community leaders need to plan for disasters, regardless of where they are. It’s an interesting inside look into how medical teams think about and respond to natural disasters.

Previously: “Still many unknowns”: Stanford physician reflects on post-earthquake Nepal, Day 6: Heading for home after treating Nepal earthquake victims, Day 4: Reaching beyond Kathmandu in treating Nepal earthquake victims, Day 2: “We have heard tales of miraculous survival” following Nepal earthquake, Day 1: Arriving in Nepal to aid earthquake victims and Reports from Stanford medical team in Haiti
Photo courtesy of Paul Auerbach

Global Health, LGBT, Public Health, Public Safety, Women's Health

Advocating for the rights of women and LGBT individuals in the developing world

Advocating for the rights of women and LGBT individuals in the developing world

Randy Barry - smallLast spring, I traveled to Washington, D.C. for my first experience as a citizen-activist, lobbying in Congress for the rights and well-being of women and LGBT individuals in the developing world. I recently returned there to see some of the impact of that work – crucial new appointees, new legislators in support of key issues and new words of encouragement from both sides of the political aisle.

I visited Washington as part of a 170-person delegation from the American Jewish World Service (AJWS), an international organization that promotes human rights and seeks to end poverty in developing countries. Our goal was to advance several initiatives, including passage of the International Violence Against Women Act, and changes to ensure that U.S. foreign contracts and foreign aid programs do not discriminate against LGBT individuals.

I was thrilled to hear a talk by Randy Berry, the State Department’s first-ever Special Envoy for the Human Rights of LGBT Persons, who assumed the new post in February. Just a year ago, AJWS had made the appointment of a special envoy one of its priority issues, and many of us, myself included, had met with our Congressional representatives to push for the position. I had been motivated by my experiences as an AJWS Global Justice Fellow in Uganda in 2014, when we met with LGBT activists who were living in a climate of terror because of the country’s impending anti-gay law. We heard stories of people who had been raped, beaten, harassed, evicted from homes and jobs and subjected to summary arrest.

I realized it was important to make LGBT rights a priority issue for U.S. foreign policy. Berry, the new U.S. envoy, said AJWS had been a “prime mover” in the creation of his new office – gratifying news indeed. He said he views LGBT rights as a “core human rights issue.”

“We are talking about equality, and it should go hand-in-hand with what we are doing in gender equality and in the disabled community,” he told us. “One of the most disturbing elements of discrimination is that it’s the first step to denying one’s humanity.”

He acknowledged that he has a daunting job ahead; while the U.S. is making swift progress on gay rights, these rights are just as swiftly being eroded in other parts of the world. Nearly 80 countries now criminalize same-sex behavior, with penalties that include death or life in prison. Yet the fact that the U.S. has made so much progress in recent decades suggests it’s possible to change the climate elsewhere as well, he said.

“Who would have dreamed 20 years ago that we would be where we are today in the United States,” he said. “I am sitting here today with the support of the State Department, the president and members on both sides of the aisle.”

We also saw progress on the International Violence Against Women Act, which would make ending violence against women worldwide a top U.S. diplomatic and development priority. Violence against women and girls is alarmingly pervasive, with as many as one in three being beaten, coerced into sex or subjected to other abuse in her lifetime.

The legislation was reintroduced in the House of Representatives in March with a record 18 co-sponsors, including many more Republicans than in the past. On the morning of our lobbying visits, we heard from seven Members of Congress, including Chris Gibson (R-NY), Richard Hanna (R-NY) and Lee Zeldin (R-NY), all of whom expressed strong support for the bill. David Cicilline (D-RI) described a trip to Liberia in which he met a group of young girls who had been subjected to “hideous, indescribable sexual violence.”

“It made me realize we need to do everything we can to change the lives of these young girls,” he told us.

I couldn’t agree more.

Previously: Stanford study shows many LGBT med students stay in the closetChanging the prevailing attitude about AIDS, gender and reproductive health in southern AfricaLobbying Congress on bill to stop violence against womenPreventing domestic violence and HIV in Uganda and Sex work in Uganda: Risky business
Photo of Randy Berry by Ruthann Richter

Chronic Disease, Global Health, Medical Apps, Stanford News

Reporting and treating cholera: Soon, there could be an app for that

Reporting and treating cholera: Soon, there could be an app for that

8424972981_35858721c7_zIn the aftermath of the 7.0 magnitude earthquake that shook Haiti in January 2010, clean water for drinking and hygiene was scarce. This set the stage for the largest cholera outbreak in recent history, killing an estimated 6,631 people. Now that a devastating 7.8 magnitude earthquake has hit Nepal, a similar situation may be in the works. Eric Jorge Nelson, MD, PhD, a pediatrician and cholera expert, is working to change this scenario with a smartphone app that he and his team are developing for use in places at high-risk for cholera outbreaks.

Although disasters and cholera often go hand in hand, the disease is also a perennial problem in places like Bangladesh and Nepal, where monsoons routinely overflow sewers and contaminate water supplies, Nelson explained. In areas such as these, about 2.8 million cases of cholera occur each year.

Time is of the essence when reporting and treating cholera. “The time it takes from when a person ingests the bacterium [Vibrio cholerae], becomes sick with diarrhea, and dies can be less than 24 hours,” Nelson told me during a recent conversation. If untreated, as many as half of the people with cholera can die, but the mortality rate drops to less than one percent if treated in time.

Therein lies the rub, Nelson explained. Many cholera-stricken areas have limited access to electricity and the tools that disease experts and doctors need to rapidly report and respond to a cholera outbreak. “The reporting mechanisms are often six-weeks delayed,” Nelson said. “We need a way to help hospitals; they need an ongoing system to provide real-time data.”

To address this problem, Nelson and his colleagues are creating a smartphone app with the aid of a $1.25-million Early Independence Award from the National Institutes of Health. Their first goal is to develop and deliver the app to doctors working in hospitals in Bangladesh, where cholera is common.

The app is a series of four pages that prompt the doctor to collect data that helps them report, diagnose and treat patients with cholera. It also contains a checklist of “danger signs” that doctors may fail to notice; this list reminds him or her to look for other illnesses that could mask or mimic cholera.

Perhaps the best feature of the app is that it’s fast. “If English is your first language, you can get through the app in roughly 60 seconds. If English is your second language, it takes about two minutes,” Nelson told me.

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Global Health, Medicine and Society

What I learned about emergency preparedness from spending 36 post-earthquake hours in Nepal

What I learned about emergency preparedness from spending 36 post-earthquake hours in Nepal

Nepal_guest_postI recently spent two weeks in Nepal starting a clinical trial for HandHero, an innovative hand splint that our team developed in Design for Extreme Affordability at Stanford, in partnership with ReSurge International. It was a very successful trip, with patients recruited and partnerships formed, and I was nearly on my way home when the earthquake struck. I recently detailed my experience in a guest blog post, and now I would like to share some of the lessons I learned about emergency preparedness. The following tips are by no means comprehensive, but they’re the key steps I would take next time I travel abroad – and they may be useful to those conducting field research or other work in developing countries.

  • Before departure: Give your close family and friends back home a list of your local contacts. Include phone numbers and a description of who these people are and the planned nature of your interactions (ie. “I will be spending most days working with this person.”). In the event of a natural disaster, it may be faster for your loved ones to contact you than vice versa.
  • Upon arrival: Get a local phone or SIM card. In Nepal, a traveler’s pack SIM card with ample local and international call, text, and data cost US $10. While voice reception could be weak, ability to send and receive texts was invaluable.
  • Cash: Always have more than enough local currency in your wallet or stored separately. Most ATMs and banks will close in the immediate aftermath of a disaster.
  • Sustenance: Pack a few energy bars for emergencies only. Bring a personal water filtration device. Keep in mind that while food and drinking water may seem sufficient immediately after a serious disaster, supplies will be hard to find and increasingly costly in the days to come.
  • Airport: Reliable information may not always be available, and airline call centers can be hard to reach. Physically going to the airport may be your best bet, and ask a trusted native speaker for help seeking out the right personnel.
  • U.S. Embassy: Keep the phone number and address of your country’s embassy handy. They can provide both logistical and practical support and will tell you whether or not there is a planned evacuation of citizens via armed forces.

AirportIf faced with a decision between leaving the country and staying on the ground to try and help with recovery efforts, consider carefully. Do you have specific skills relevant to the situation at hand? Do you speak the language? Could you be of more help staying in the country or back home raising awareness and support? While it may be extremely compelling to stay, it might not always be the best option depending on your situation.

Finally, take good care of yourself upon your eventual return. My first few days back in the Bay Area seemed very surreal, as the reality of what occurred only hit home after the adrenaline died down. Unforgettable life experiences often happen when we least expect, and the best we can do is to stay equipped with communication capabilities and basic supplies.

Jana Lim is a PhD candidate in neurosciences at Stanford. Her thesis research focuses on molecular mechanisms of associative learning in C. elegans. Lim’s involvement in Design for Extreme Affordability stems from her long-standing interest in sustainable development and her desire to create more applied solutions to existing social issues.

Previously: “Still many unknowns”: Stanford physician reflects on post-earthquake Nepal, Day 6: Heading for home after treating Nepal earthquake victims, Day 4: Reaching beyond Kathmandu in treating Nepal earthquake victims, Day 2: “We have heard tales of miraculous survival” following Nepal earthquake and Day 1: Arriving in Nepal to aid earthquake victims
Photos by Jana Lim

Global Health, Health Disparities, Health Policy, In the News, Medicine and Society

Why millions lack access to surgery: A conversation with Stanford surgeon Thomas Weiser

Why millions lack access to surgery: A conversation with Stanford surgeon Thomas Weiser

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In the United States, many routine surgeries are just that: routine. They may or may not correct the condition, but the likelihood of death or of life-changing complications are minimal.

But if you live in a poorer nation, surgery — even a cesarean birth — is quite risky and hard to procure. For as many as 5 billion people, these basic procedures are out of reach, according to a recent report by the Lancet Commission, the focus of a recent Scope post and many other news articles.

There are numerous reasons for this surgical gap, as Stanford surgeon Thomas Weiser, MD, who contributed to the report, explains in an Inside Stanford Medicine Q&A.

First, surgery “requires a strong and continuous supply chain, highly technical skills and ongoing training, and intensive management to organize such services,” Weiser said. In addition, most aid programs focus on a specific disease, while surgery is a therapy, leaving it outside the bounds of most international development programs, he said.

So what does the future hold? Weiser is optimistic:

I hope that these findings and the new data presented in the commission report will increase attention and awareness of the vital role surgical care plays in a health system. Ideally, we will see increased leadership from organizations like the WHO and the World Bank in the form of attempts to standardize data collection, identify high-performing health systems, publicize successful programs and promote their adoption and replication in other health settings, and support improved investments in surgical capacity and quality improvement as a way to strengthen the health system more generally.

Previously: Billions lack surgical care; report calls for change, Stanford Medicine magazine opens up the world of surgery and Global health expert: Economic growth provides opportunity to close the “global health gap”
Photo by skeeze

Emergency Medicine, Global Health, Stanford News

“Still many unknowns”: Stanford physician reflects on post-earthquake Nepal

"Still many unknowns": Stanford physician reflects on post-earthquake Nepal

Paul Auerbach recently traveled to Nepal to aid victims of the April 25 earthquake; he wrote this post over the weekend.

17313678335_5f5d15dc04_zI’m on my way back to the U.S. now and getting information from people who are still in Nepal. Because I’m inundated with requests to provide information from people who have read my previous posts, I’ll keep writing, but only if there’s something useful to report. Please let me emphasize that this is no longer firsthand, but rather, based on communications from persons in Nepal whom I very much trust. They are working really hard, so it is “above and beyond” (and very much appreciated) that they find time to keep us all informed.

Surrounding Kathmandu and seen from the air, there are many remote villages that have been devastated, with all or nearly all dwellings demolished by the earthquake. These buildings had mostly been constructed of bricks mortared with mud. They crumbled during the shaking and may have been struck by rock slides. Anyone caught within the buildings could have been mortally wounded or severely injured.

Many villages are situated one or more days’ walk from the nearest vehicle (4-wheel drive truck or SUV)-accessible roadway, so rapid access will need to be by helicopter if there is a suitable landing site or the ability to carry out long-line rescues (this requires the appropriate equipment and operators with technical expertise, both on the ground and in the helicopter). Helicopters are in short supply relative to the need, so that is a rate-limiting part of the operation. The helicopters will be needed both to get teams in and to get patients out. The first step will be to provide on-site triage in order to prioritize where to deploy medical and other resources. Patients will be assessed in order to determine whom to transport and in what order. Treatment will be initiated when possible. The possibility of trekking into villages will be dictated by the condition of the paths normally used for foot travel. The paths are often narrow, rocky, and steep. It is likely that there have been rock-and-dirt slides that will render traversing some of these paths extremely difficult or impossible. If the paths are passable, that may be how some of these villages will eventually be reached, and people and supplies delivered. The delays will be overcome by cooperation and perseverance.

Medical teams from around the globe have come into Kathmandu and are assisting or prepared to assist. They will be responsive to the Nepal government, global-health agencies such as the World Health Organization, and non-governmental organizations such as International Medical Corps. The search and rescue (SAR) component intended to find victims trapped in rubble will expect from this point forward to find only a few miraculous survivors of the initial event, so the role of SAR to extricate buried people will diminish. From this point forward, it will be about getting to the injured and sustaining them until they can be extracted to a higher level of medical care, if this is what they need. Reaching all the affected villages and injured persons may take weeks. To assist displaced (e.g., no longer have a home) persons, there is need to provide food, sheltering materials, and water disinfection supplies.

The public-health mission, in particular trying to prevent the spread of potentially epidemic infectious disease (particularly diarrheal disease) is hugely important. This is essential now and particularly as the monsoon season approaches. This includes human-waste management, providing safe drinking water, possibly providing immunizations, and surveillance that promotes early detection of disease.

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Emergency Medicine, Global Health, Stanford News

Day 6: Heading for home after treating Nepal earthquake victims

Day 6: Heading for home after treating Nepal earthquake victims

Paul Auerbach has been in Nepal to aid victims of the recent earthquake; he wrote this account over the weekend.

Nepal earthquake2 - smallThe last few days have been action-packed, and my work in Nepal is coming to a close. As an emergency physician, my skills will soon be much less needed than those of orthopedic and plastic surgeons, and primary care and infectious disease specialists. Because of the incredible outpouring of active interest from people who are friends of Nepal, many health-care professionals have arrived, and more are on the way. The government of Nepal has recommended that all persons, particularly those in large groups or teams, wishing to help by coming to Nepal do so under the auspices of a government-approved organization. This is important to maintain an effective response and deploy resources where they are most needed.

It has been a bit unnerving to experience three significant aftershocks over the past few days. Each was accompanied by a jolt or shaking of the ground or building and rumbling noise, followed by silence, followed by the sounds of commotion as people fled their dwellings. Fortunately, none of the aftershocks was prolonged or destructive, but they serve as a reminder of what happened, and what will undoubtedly happen again sometime in the future. The cycle for a major earthquake in this country in modern times is approximately every 75 years.

Today we traveled to Hatia, a community close to Dhading, in order to assess need and provide care. We were greeted by approximately 100 residents with earthquake-related situations, illnesses, and injuries. Nearly all of them are now displaced from their homes. With the monsoon on the horizon beginning the end of this month or early in June, combined with the number of persons requiring new shelter, the timetable is set for an aggressive attempt to provide adequate housing, essential public health education, and water-sanitation-hygiene (WASH) programs. More victims of the earthquake will undoubtedly be found as helicopters are deployed to approach very difficult-to-reach areas, so there will continue to be an immediate medical response as long as the public health efforts.

I have witnessed many acts of selflessness and heard tales of amazing bravery, including what transpired at Everest Base Camp. The details of everything that has happened in this country related to the earthquake will be best told by those who experienced it first-hand. From a personal perspective, I’m impressed by the number of participants in the events and response that has come from the wilderness medicine community. These are some of my dearest friends and colleagues, and my admiration for them has grown by leaps and bounds. Working with my lifelong friend Luanne Freer, MD, has been a privilege. Her knowledge of Nepal and love for the country permeated everything she did this past week. There are many people like her who have come to help, and behind every person here there are dozens at home supporting their efforts.

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Emergency Medicine, Global Health, Stanford News

Day 4: Reaching beyond Kathmandu in treating Nepal earthquake victims

Day 4: Reaching beyond Kathmandu in treating Nepal earthquake victims

Paul Auerbach is in Nepal to aid victims of the recent earthquake and has been sending periodic reports.

The earthquake in Nepal caused immense damage to people and property not only in Kathmandu, but in a widespread area extending to Mt. Everest and in many other directions. Victims on Mt. Everest and in Kathmandu proper appropriately received a great deal of attention, but equally important has been the plight of persons trapped in villages remote from the big city. These communities are located in steep and isolated terrain, so that it is difficult to reach them by road, and sometimes even by helicopter. Part of the mission of International Medical Corps (IMC) and the other responding organizations has been to identify these areas of need and attempt to locate and treat the victims.

We continue to see improvement each day, and the number of volunteers from around the world is impressive

After a discussion with three health officials – the senior district health officer for Dhading, a pediatrician assigned to lead the district medical response to the earthquake, and the medical supervisor for the Dharding District Hospital, we were asked to consider finding a way to approach one of several villages that were reported to have urgent medical needs, but which had not yet been visited by rescuers and medical professionals. We selected Kumpur, a rugged 90-minute approach requiring a 4-wheel drive vehicle. We excluded others that required helicopter access, because these aircraft have been in short supply.

At the Dhading District Hospital, we witnessed arrival of a dozen earthquake victims choppered in from Darkha, which is at a high elevation in this region. They were suffering from trauma, with broken limbs and wounds in various stages of infection. The Nepalese doctors who volunteered their time by leaving Bangladesh to respond at the request of IMC, alongside a (literally) busload of surgeons and other medical professionals volunteering from India were skilled and swift in delivering treatment despite the limited resources and surge of patients.

The next day, we took a team into Kumpur and witnessed widespread destruction amid the beautiful surroundings. Many dwellings composed of mud and stone had collapsed, and the residents are now living in tents. With the monsoon season approaching, they will need assistance to rapidly create more suitable structures. They were busy clearing the remains of their homes and other structures, but always gave us a smile and a greeting. Their resilience and work ethic are amazing.

The health outpost has been rendered largely unusable, with large cracks in its side, holes in the wall, and instability in every direction. So, we worked mostly in the single safe room remaining and on the porch leading to the entryway. With a stellar support team, including two recently graduated doctors from Nepal, we were able to interview and examine many of the villagers, dealing with complaints both related to injuries sustained in the earthquake and medical conditions for which they sought advice.

As the days pass, fewer patients will present with acute earthquake-related injuries, and the medical care will shift to resumption of adequate primary care, surgeries related to orthopedic and soft tissue injuries, and aggressive detection and management of infectious diseases that might cause an epidemic. Public-health experts are on-scene, as are epidemiologists and other experts in sanitation systems, water disinfection, and so forth. Given the large geographic area affected by the earthquake and difficulty reaching many locations, the logistics are extremely important.

We continue to see improvement each day, and the number of volunteers from around the world is impressive. We hope for the best and appreciate all the support we’ve received from family and friends.

Paul Auerbach, MD, is a professor and chief of emergency medicine who works with the Stanford Emergency Medicine Program for Emergency Response (SEMPER).

Click here for a statement on Nepal from Michele Barry, MD, senior associate dean of global health and director of the Center for Innovation in Global Health (CIGH). Additional updates related to the Stanford relief efforts will be shared on the CIGH website in the coming days and weeks.

Previously: Day 2: “We have heard tales of miraculous survival” following Nepal earthquake and Day 1: Arriving in Nepal to aid earthquake victims

Events, Global Health, Health Policy, Pediatrics, Stanford News, Videos

Rajiv Shah discusses efforts to end preventable child deaths worldwide at Childx

Rajiv Shah discusses efforts to end preventable child deaths worldwide at Childx

The inaugural Childx conference was held here this month, and video interviews featuring keynote speakers, panelists and moderators are now on the Stanford YouTube channel. To continue the discussion of driving innovation in maternal and child health, we’ll be featuring a selection of the videos this month on Scope.

More than six million children under the age of five die from preventable diseases each year. During this year’s Childx conference, Rajiv Shah, MD, the former administrator of USAID, told the crowd, “I do think it’s possible to end preventable child death.”

In the video above, he explains how innovations in drug development, diagnostics and vaccines are among the solutions that are effectively reducing child mortality rates around the world. But there is still more that can be done. Using global health data to see in real-time where children are dying because of a lack of vaccines and places children are suffering as a result of poor health care, Shah said, could assist in more efficiently directing resources to these areas and other pockets of need. Watch the full interview with Shah to hear more about why he thinks ending preventable child death is achievable in the next 20 years.

Previously: Childx speaker Matthew Gillman discusses obesity prevention, Pediatric health expert Alan Guttmacher outlines key issues facing children’s health today, “It’s not just science fiction anymore”: Childx speakers talk stem cell and gene therapy and Global health and precision medicine: Highlights from day two of Stanford’s Childx conference

Emergency Medicine, Global Health, Stanford News

Day 2: “We have heard tales of miraculous survival” following Nepal earthquake

Day 2: "We have heard tales of miraculous survival" following Nepal earthquake

Paul Auerbach is in Nepal to aid victims of the recent earthquake and has been sending periodic reports.

Today in Kathmandu was quite different from yesterday. The city has certainly sprung back remarkably. Although its citizens face enormous challenges, the streets were nearly full with traffic, rubble was actively being cleared from obstructing piles, and people were walking and resuming commerce. There are an estimated 16 camps within the boundaries of Kathmandu, where people are either forced to seek housing or prefer to remain, certainly for sleeping at night, until homes can be replaced or cleared with respect to structural integrity. The camps are orderly and treated with dignity by the occupants and passers-by. We visited one this afternoon to perform a clinic, examining patients who wished to see a physician. Because the hospitals in Kathmandu received the injured soon after the earthquake, we mostly served persons with “routine” medical ailments. They were kind to us and appreciated the attention.

International Medical Corps continues to grow its staff and operations to meet the evolving situation. Side by side with other entities that have responded, including large national emergency response teams, there will be increasing focus on the communities outside Kathmandu, where there is sparse medical care and distances to hospitals mean walks of hours. Some of these will need to be approached by helicopter because of distances, mud- and rockslides caused by the earthquakes that have obstructed roadways, and calls for urgent assistance. It’s anticipated that some teams may need to trek for days to reach certain villages. Much of the coming days’ and weeks’ activities will be intended to avoid the spread of infectious diseases.

We have heard tales of miraculous survival, sadly posed against the grief of many lost family members and friends. Driving through the city past enormous mounds of rubble that last week were sacred temples and monuments, it is striking to think about how much there is to be done worldwide to prepare for cataclysmic natural events. There will be many lessons learned from this catastrophe, and we should take them to heart. One of them is how much better is a world focused on mutual aid and skillful compassion than upon dominance and conflict.

Paul Auerbach, MD, is a professor and chief of emergency medicine who works with the Stanford Emergency Medicine Program for Emergency Response (SEMPER).

Click here for a statement on Nepal from Michele Barry, MD, senior associate dean of global health and director of the Center for Innovation in Global Health (CIGH). Additional updates related to the Stanford relief efforts will be shared on the CIGH website in the coming days and weeks.

Previously: Day 1: Arriving in Nepal to aid earthquake victims

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